Which Is More Effective: Laparoscopic or Open Partial Cholecystectomy?

Abstract

Objective: In laparoscopic cholecystectomy, partial cholecystectomy is usually preferred when the anatomic exploration is not enough to prevent bile duct injury and other complications. Some surgeons choose laparoscopically to perform partial cholecystectomy, whereas others convert to open surgery. In this study, we aim to discuss and compare the effectiveness of laparoscopic partial cholecystectomy (LPC) and open partial cholecystectomy (OPC). Materials and Methods: The data of 4712 patients who underwent laparoscopic cholecystectomy between 2012 and 2020 were reviewed. A total of 98 patients who had partial cholecystectomy were included in the study. Patients were examined in two groups according to whether the procedure was open or laparoscopic. The first group of patients was named the OPC group (n = 52), and the second group of patients was the LPC group (n = 46). The data of the two groups were comparatively analyzed. Results: The mean operative time and the postoperative hospital stay, respectively, were 118.2 minutes and 4.8 days in the OPC group, and 87.3 minutes and 2.55 days in the LPC group (P < .005 and P = .005). It was found that wound infection decreased by 83.1% (P = .026; odds ratio [OR] = 0.169) in the LPC group compared with the OPC group, and the probability of developing incisional hernia decreased by 81.1% (P = .014; OR = 0.189). At least one complication was observed in 17 patients in the OPC group and in 7 patients in the LPC group (P = .045). The probability of developing complications in any patient was 63% lower in the LPC group (P = .049; OR = 0.370). Conclusions: The indications that cause the surgeon to perform partial cholecystectomy are inherently open to complications, regardless of the surgical technique used. However, the laparoscopic operation has advantages such as shorter operation time, shorter postoperative hospital stay, lower risk of wound infection and incisional hernia rate, and lower complication rate than the open procedure. However, if the team performing the surgery does not have enough experience, they should never hesitate to switch to open cholecystectomy.

Therapeutic Effect of Laparoscopic Cholecystectomy on Patients with Cholecystolithiasis Complicated with Chronic Cholecystitis and Postoperative Quality of Life

“…In recent years, laparoscopic cholecystectomy has been widely used in the clinical treatment of patients with chronic cholecystitis and gallbladder stones [ 25 , 26 ]. As the gold standard for the treatment of gallbladder disease, laparoscopic cholecystectomy has the advantages of being minimally invasive, small incision, less pain, and quicker postoperative recovery, and is conducive to preserving the contractile function of the gallbladder [ 27 , 28 ]. In recent years, extensive research has been undertaken on the treatment of gallbladder stones and chronic cholecystitis [ 29 ].…”

Laparoscopy vs. Laparotomy for the Management of Abdominal Trauma: A Systematic Review and Meta-Analysis

“…Wound infection was the most commonly encountered complication in this review, with an overall incidence of 2.53% in the laparoscopy group, which was far lower than laparotomy. This is consistent with other studies that showed fewer wound infections following laparoscopic procedures, such as appendectomy ( 47 ) and cholecystectomy ( 48 , 49 ). This could be due to the reduced surgical stress and tissue trauma that is imposed on the patient as a result of the minimally invasive approach.…”

State of the art in subtotal cholecystectomy: An overview

“…Open subtotal cholecystectomy has been associated to higher risk of reintervention, surgical site infection and 30-day mortality, with lower risk of bile leakage compared to laparoscopic subtotal cholecystectomy (27, 29). Longer operation time, longer postoperative hospital stay and higher incisional hernia rates have also been reported in open subtotal cholecystectomy (29).…”